Genetic testing to determine your ‘healthspan’ can provide valuable information about the risk factors you face in later life - but is unlikely to put off the inevitable, writes Sophie Morris
I expected to feel anxious when my DNA test results dropped. Would they show something unusual and untreatable, perhaps, or forecast long-term ill health? Maybe, I worried, they would tell me to stop eating cheese.
I’d only done the £99 saliva test, with biotech firm FitnessGenes, as part of an investigation into my potential “healthspan”, a buzzword but also an important field of study in health and wellbeing circles.
Healthspan advocates encourage us to focus not on how long we’ll live, but on how many of those years we’ll be in good working order.
What I hadn’t expected, as I hovered over my results dashboard, was the accompanying ego. It’s possible, I conjectured, that this simple saliva test will reveal me to be not just the exhausted mid-life mother I appear on the outside, but a superhuman carrying genes that predict I will cheat illness, outlive my peers, and - who knows - remember where I parked the car in the multi-storey.
The results are somewhat more prosaic, although they do make me cry.
FitnessGenes, a female-led, Bicester-based business founded 10 years ago and chaired by Bupa’s former chief medical officer Dr Andrew Vallance-Owen, uses genetic testing alongside lifestyle information to develop a rounded picture of an individual’s health.
It doesn’t predict disease as such, but by pinpointing our greatest health risks, say co-founders Dr Samantha Decombel and Dr Stuart Grice, both PhDs in genetics, we can take actions to reduce the likelihood of developing the illnesses our DNA says we’re most at risk from.
Why the tears? It turns out I have a slew of risk factors for putting on weight, from not being able to detect fat on a taste level, to a low metabolic rate, a risk of addictive and impulsive eating behaviours, leptin resistance (which causes overeating), and several FTO (fat mass and obesity associated) gene variants that are linked to increased hunger, fat storage, and obesity risk.
I’m not crying because I’m worried about becoming obese or developing diabetes.
On the contrary, I am thrilled. This information makes me feel that the weight isn’t my fault. But it does explain why I’ve always found it so hard to lose even a single pound.
FitnessGenes identifies and analyses hundreds of genes but points out that looking at genes in isolation is only part of the story.
I can also tell you that the names and numbers mean nothing to a layperson. But the results are analysed to compile a personalised report made up of the “traits” your genes reveal, and actions you can take to manage what your DNA reveals.
For my obesity gene, for example, it’s suggested that I substitute fatty snacks with almonds, carrots or dark chocolate, have avocado on toast instead of butter, and take a break or go for a walk to check if I’m full before ploughing on.
I’m willing to make some changes but know that obsessive tracking can lead to as many bad habits as good, especially when those selling health and wellbeing products dial into diet culture.
What else? I feel a little bump of pride on reading that I have two copies of the ACE gene’s I allele (II), associated with elite endurance athletes and climbers. I am definitely the tortoise in any race, and have never struggled at altitude.
For the HERC2 gene, associated with melanin production and therefore eye, hair and skin colour, I have two copies of the G allele (GG), something only 10 per cent of us have, which suggests an 84 per cent chance of blue eyes.
What can knowing all this do for my healthspan?
“It’s person-specific,” says Dr Grice. “Some people are going to have no obvious red flags. But there’ll be some people you look at and say: ‘I believe that you should apply significant lifestyle changes’.”
I’m aware that I should lose a few kilos, move more and build muscle.
The importance of resistance training is a topline piece of advice from FitnessGenes, but at the moment the closest I get to resistance is turning down a third glass of wine.
Surely the key thing is to stick to any good intentions - does the personalisation approach lead to over-complication?
“When it comes to generic lifestyle advice, broadly that’s not working,” says Dr Grice. “Because you’re fighting against an obesogenic environment. The section on our website on weight loss is set out depending on your hunger, or your addictive and impulsive eating behaviours, for example.”
Dr Decombel tells the story of her own mother’s high cholesterol and blood pressure.
She had been following general NHS advice for 10 years, with no change. Dr Decombel recommended a diet high in cholesterol-fighting nutrients, including soy, oats, garlic, flaxseed and plenty of fibre.
Within three months, her mother’s cholesterol had dropped by 25 per cent. Dr Decombel’s family has a history of heart problems, but she imagines that by not smoking or drinking heavily, as many of them have, she has already given herself another 10 years.
It is hard to prove specific efficacy. Given the aim is to head off disease at the embryonic stage, it’s impossible to show what most interventions do.
Dr Decombel, 42, and Dr Grice, 43, are life partners and co-parents as well as business partners. As a couple at the forefront of a movement that is variously called optimised, personalised, preventative, proactive, or precision healthcare, what ambitions do they have for their own future fettle?
“You can never tell how long you’ve got,” says Dr Decombel. “Anyone who says they can isn’t being honest with themselves.”
“For me there’s a philosophical argument between what is a long life and what is a good life,” adds Dr Grice. “This desire for longevity is problematic. Helping people have a long healthspan is incredibly good for society as it reduces the cost of healthcare, but I’m very sceptical about the drive for longevity. It’s egotistical and doesn’t support the narrative of improving healthcare across the population.”
On his Disney+ show Limitless With Chris Hemsworth, the Hollywood actor has spoken about looking into his DNA.
He found he has two gene variants associated with a huge increased risk of Alzheimer’s, and decided to put acting to one side and focus on his family.
“He is thinking about his life in terms of the possibility he’ll have dementia by 70, and what he can do in terms of reducing stress, eliminating alcohol, taking up particular types of exercise, taking omega-3 oils - all things which can add to your life,” explains Dr Grice.
Dr Peter Attia, who broke the news to Hemsworth while they were making the show, says that finding out this information at 37 is of huge benefit when it comes to mitigating the onset of cognitive decline.
While we’re on the topic of La La Land, Dr Grice alludes to some of the more sci-fi aspects of the antiageing industry, mentioning scientists David Sinclair and Aubrey de Grey, who talk about reversing ageing and - wait for it - immortality.
In their world, vampires remain mythical, but feasting on the blood of the young is fair game. In fact it’s a health trend, albeit one reserved for the extremely wealthy, most of whom are looking for ways to spend their tech billions.
It’s not even happening under cover of darkness; 45-year-old Silicon Valley entrepreneur Bryan Johnson is telling anyone who’ll listen about his blood-swapping activities with his 17-year-old son and 70-year-old father.
The concept of parabiosis, tested in mice, shows that when two animals are surgically joined and their blood runs together, they develop a single, shared, physiological system.
Johnson made his money selling payment processing technology, but is now focused on fighting - and reversing - the effects of ageing, using himself as the obsessively-measured guinea pig in a project which costs him $2m (£1.5m) a year.
Thankfully he has so far spared his son an operation to surgically connect their two bodies. Others who talk of their interest in rejuvenating blood injections include Pay- Pal co-founder Peter Thiel, who has said he plans to live to 120, and Amazon’s Jeff Bezos. Some of the most out-there figures predict we’ll have discovered how to conquer ageing by 2035 or 2050.
Most of us know we must accept the inevitable - death. When UK life expectancy is almost stagnant, and declining in poorer demographics, does the madcap optimism of healthspan nuts bear any relevance for mere - well - mortals? Those of us who don’t have a “high frequency electromagnetic simulation device” that helps our bodies to perform the equivalent of 20,000 sit-ups in 30 minutes, as Bryan Johnson does - and most likely don’t want one.
Last week the Health Foundation forecast worrying health patterns in the UK, predicting 9 million people living with chronic illnesses such as dementia, diabetes, cancer, depression and kidney disease by 2040. This is 2.5 million more than in 2019.
We already spend 86 per cent of the healthcare budget fighting these kinds of illness, and only 2.8 per cent on preventative care.
You don’t need a DNA test to make lifestyle changes, though more organisations like FitnessGenes are springing up to offer programmes and courses to keen users.
If you have already paid for testing via Ancestry or 23andMe, you can use these to access health insights. Other companies offer advice via blood tests or microbiome analysis. Choose from DNA Fit, Atlas Biomed, Viome, Healthpath or Zoe - you’re sure to find a test to suit.
Though aimed at the “worried well”, who are probably already spending on gym memberships and supplements with add-ons for exercise plans, the process is more accessible than I expect.
The GHS is another online health service that aims to fill the preventative medicine gap the NHS simply cannot shoulder, offering over-50s a platform crammed with personalised nutrition and exercise classes, alongside cognitive support via short courses in painting and cooking.
It feels like a warm hug compared to the blood-sucking Silicon Valley lot. We can all benefit from looking at our healthspans more closely, even without huge sums of money or spare time.
Retirement is sold to us as a period of rest and relaxation. We can’t prevent many illnesses or accidents, but perhaps we can ease our passage towards the inevitable.
FAST FACTS HEALTHSPAN
Podcaster Peter Attia is the doctor who guided Chris Hemsworth through his DNA discovery journey, via the TV show Limitless with Chris Hemsworth. In his book Outlive: The Science and Art of Longevity (Vermilion, £22), which came out earlier this year, Dr Attia says that improving healthspan boils down to avoiding or delaying decline in three categories that affect our quality of life.
Cognitive decline: loss of executive function, processing speed and memory (all can be pervasive before dementia itself)
Physical decline: loss of stability, flexibility, mobility, strength, muscle mass, bone density, aerobic efficiency, sexual function and increased pain
Emotional decline: loss of social support, relationships, sense of purpose “While death is absolute and inevitable, a loss of the three elements of healthspan is not,” says Dr Attia
JUST FIVE THINGS
The five areas to target for improving healthspan, according to Dr Attia are: 1. Nutritional biochemistry (what we eat) 2. Exercise physiology (how we exercise) 3. Sleep physiology (getting more and better sleep, often called sleep hygiene) 4. Mental and emotional health 5. Medication and supplements